ABSTRACT
OBJECTIVE: To develop a predictive pressure ulcer risk assessment scale based on patient data. METHOD: Detailed questionnaires, based on a review of the paediatric and adult literature and discussion with paediatric nurses with expertise in this area, were used to obtain data on patient characteristics from 265 inpatients in a children's hospital and 54 children with pressure ulcers and 17 children without pressure ulcers from 11 hospitals. These data were then combined to compare the characteristics of children with and without pressure ulcers (using the chi-square test). RESULTS: The Glamorgan paediatric pressure ulcer risk assessment scale was developed, based on the significance values identified by the statistical analysis. Variables that were significantly (p<0.01) associated with pressure ulceration included: difficult to position, anaemia, equipment pressing or rubbing against skin, reduced mobility for age, prolonged surgery and persistent pyrexia. The sensitivity, specificity and predictive validity of the Glamorgan scale was found to be greater than those for the Braden Q scale, which is widely used to assess pressure ulcer risk in children in the US. CONCLUSION: Using patient data from children and young people in the development of risk assessment tools for this age group may be preferable to modifying existing adult tools.
Subject(s)
Nursing Assessment/methods , Pediatric Nursing/methods , Pressure Ulcer/diagnosis , Risk Assessment/methods , Adolescent , Case-Control Studies , Chi-Square Distribution , Child , Child, Preschool , England/epidemiology , Female , Hospitals, Pediatric , Humans , Incidence , Infant , Male , Nursing Assessment/standards , Nursing Evaluation Research , Pressure Ulcer/epidemiology , Pressure Ulcer/etiology , Pressure Ulcer/nursing , Prevalence , Risk Assessment/standards , Risk Factors , Sensitivity and Specificity , Surveys and QuestionnairesABSTRACT
There is very little published literature on pressure sores in children and most of the existing literature is qualitative. Using literature from paediatric and adult studies, a schedule was designed to collect quantitative data on aspects that may predispose children to pressure injury. The schedule was piloted in an incidence and a prevalence study at the Royal Liverpool Children's NHS Trust. The sample size was 82 children for the incidence study and 183 children for the prevalence study. Six children in the incidence study and 12 children in the prevalence study sustained pressure injury. Data indicated that factors most strongly associated with pressure injury were nutritional status, mobility and consciousness level. Other factors that were implicated in increasing susceptibility to pressure injury were skin condition, body weight, haemodynamic status and hydration. Infants and young children most frequently sustained pressure injury on the occipital scalp area and heels. Although this was a small study, it produced some useful preliminary data, and was a valuable exercise to develop a tool for data collection on a larger scale.
Subject(s)
Child, Hospitalized/statistics & numerical data , Pressure Ulcer/epidemiology , Acute Disease , Child , Child, Preschool , Humans , Incidence , Infant , Prevalence , United KingdomABSTRACT
Many information booklets are written by health-care staff and may not address patients' needs. Collaboration between patients and staff in the production of patient information can improve patient understanding and empower the patient and family to take an active part in treatment.
Subject(s)
Family/psychology , Pamphlets , Patient Education as Topic/methods , Adolescent , Adult , Child , Child, Preschool , Health Services Needs and Demand , Humans , Nephrotic Syndrome/psychology , Pediatric Nursing/methods , Professional-Family RelationsABSTRACT
This article presents the findings from the evaluation of nurse prescribing, undertaken in eight demonstration sites since October 1994. The authors examine in particular the nurses' prescribing behaviour and the type of items nurses and GPs would like to see added to the formulary. The opportunities for prescribing and the limitations of the formulary for health visitors and practice nurses are highlighted.
